Bisphosphonates-induced avascular osteonecrosis of the jaws is often reported after treatment of multiple myeloma.
Currently, the number of cases of this osteonecrosis described in the literature is approximately 1500.
Mr. A.L of 62 years old and treated for a multiple myeloma IgG stage IIIa by intravenous bisphosphonates associated
to chemotherapy and corticotherapy. This patient developed an osteonecrosis of the jaws following teeth
avulsions. The radiological exam discovered a large osteolyse of the right posterior region of mandible. This patient
treated by an ablation, under general anesthesia, of bone sequestrum associated to an antiseptic and antibiotic
treatment and a hyperbaric oxygen treatment. Bisphosphonates-induced osteonecrosis of the jaws affect patients aged of 61 years old of white race and seat
with predilection in posterior region of mandible. Treatments by pamidronate or zoledronic acid, previous dental
extraction, advanced age of the patient, posology and the length of exposition to bisphosphonates have been
implied in the development of this osteonecrosis. Currently, the recommended treatment for this osteonecrosis is
essentially symptomatic and conservative. The preventive treatment consists on a complete dental evaluation performed
before commencing bisphosphonate treatment. (Med Buccale Chir Buccale 2009 ; 15 : 39-44).

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